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38 Cards in this Set
- Front
- Back
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The most common type of hypothyroidism
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Hashimoto's thyroiditis
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Lab findings in Hashimoto's thyroiditis |
High TSH, low T+ antimicrosomal antibodies |
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Exophthalmos, pretibial myxedema, and ↓ TSH Diagnosis? |
Graves' disease |
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The most common cause of Cushing's syndrome? |
Iatrogenic corticosteroids
second is Cushing's disease |
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A patient presents with signs of hypocalcemia, high phosphorus, and low PTH
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Hypoparathyroidism
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"Stones, bones, groans, psychiatric overtones"
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Signs and symptoms of hypercalcemia
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A patient complains of headache, weakness, and polyuria; exam reveals hypertension and tetany. Labs reveal hypernatremia, hypokalemia, and metabolic alkalosis. |
1◦ hyperaldosteronism (due to Conn's syndrome or bilateral adrenal hyperplasia) |
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A patient presents with tachycardia, wild swings in BP, headache, diaphoresis, altered mental status, and a sense of panic.
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Pheochromocytoma
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Should α- or β- antagonists be used first in treating pheochromocytoma? |
α- antagonists (phentolamine and phenoxybenzamine) |
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A patient with a history of lithium use presents with copious amounts of dilute urine
Diagnosis? |
Nephrogenic diabetes insipidus (DI)
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Treatment of central DI?
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Administration of DDAVP ↓ serum osmolality and free water restriction
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A postoperative patient with significant pain presents with hyponatremia and normal volume status
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SIADH due to stress
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An antidiabetic agent associated with lactic acidosis
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Metformin
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A patient presents with weakness, nausea, vomiting, weight loss, and new skin pigmentation. Labs show hyponatremia and hyperkalemia. Treatment?
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1 adrenal insufficiency (Addison's disease). Treat with replacement glucocorticoids, mineralocorticoids, and IV fluids
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Goal HB-A1c for a patient with DM |
6 |
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Treatment of DKA
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Fluids, insulin, and aggressive replacement of electrolytes (eg. K+)
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Why are β-blockers contraindicated in diabetics?
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They can mask symptoms of hypoclycemia
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Insulin regular Onset Peak Duration |
Insulin regular Onset = 10 min Peak = 1 hr Duration = 2-4 hr |
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Insulin regular Onset Peak Duration |
Insulin regular Onset = 10 min Peak = 1 hr Duration = 2-4 hr |
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NPH Insulin Onset Peak Duration |
Insulin NPH Onset = 2hr Peak =6-10 hr Duration = 18-24 hr |
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Insulin glargine Name Onset Peak Duration |
Insulin glargine Name = Lantus Onset = 2 hr Peak = none Duration = 24+ hours |
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Insulin glargine Name Onset Peak Duration |
Insulin glargine Name = Lantus Onset = 2 hr Peak = none Duration = 24+ hours |
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Insulin detemir Name Onset Peak Duration |
Insulin detemir Name = Levemir Onset = 2hr Peak = none Duration = 6-24 hr |
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Insulin glargine Name Onset Peak Duration |
Insulin glargine Name = Lantus Onset = 2 hr Peak = none Duration = 24+ hours gLargine = Lantus =Long
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Insulin detemir Name Onset Peak Duration |
Insulin detemir Name = Levemir Onset = 2hr Peak = none Duration = 6-24 hr |
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DM 2 Order of drug initiation |
1. Metformin 2. Sulfonylurea or TZD (gliptine) 3. Insulin |
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Adjust insulin a.m. Glucose low |
Change evening NPH |
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Adjust insulin a.m. Glucose low |
Change evening NPH It takes pt through the night |
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Adjust insulin Noon Glucose low |
Change a.m. Regular It takes pt through the morning |
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Adjust insulin 5 p.m. Glucose low |
Change a.m. NPH It carries pt through day |
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Adjust insulin Bedtime Glucose low |
Adjust dinner regular It carries pt through evening |
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Somogyi effect Cause Tx |
Glucose Sinks = Somogyi --> catecholamines --> incr BG in early a.m.
Tx: decr evening NPH |
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Dawn phenomenon Cause Tx |
Glucose rises = Dawn Evening NPH too low --> glucose stays high
Tx: incr evening NPH |
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Distinguish Somogyi vs Dawn phenomenon |
Do 3 a.m. Glucose
Low = Somogyi (sinks) High = dawn (rises) |
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DKA vs HHNK |
DKA BG 300-800. Acidosis Ketones
HHNK BG >800. No acidosis No ketones |
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DM 2 Drug choice Start with Add |
Start with Metformin Add Sulfonylurea or TZD |
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When to add insulin |
A1C consistently over 8.5 |
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Diagnostics for metabolic syndrome |
3/5 - Waist circumference >40 in men, 35 in women - TG > 150 - HDL < 40 men. < 50 women - BP> 130/85 - fasting BG > 100 |
